Democratic Senators Ask Biden Administration to Mandate Coverage of OTC Birth Control

Recent FDA ruling paves the way for such drugs to be available in pharmacies and drugstores for purchase without any oversight from a doctor.

Birth control.
Birth control. (photo: Selbe via Flickr / (CC BY-NC-ND 2.0))

A group of Democratic senators is asking the White House to require insurance companies to cover over-the-counter (OTC) hormonal birth control, which was recently approved by federal regulators. 

The U.S. Food and Drug Administration in July approved the first nonprescription oral contraceptive, called “Opill.” The drug is expected to be available in pharmacies and online in 2024.

Previously, oral contraceptives required a doctor’s visit and a prescription for women to access them. The FDA’s ruling paves the way for such drugs to be available in pharmacies and drugstores for purchase without any oversight from a doctor. 

In their letter last week, the Democratic senators asked the Biden administration to “ensure coverage for OTC contraceptive products” in “all federally and state-regulated private health plans and federally and state-regulated and run coverage programs.”

The senators suggested the administration could add the OTC pill “to an existing coverage requirement and/or formulary” and “eliminate any otherwise-required cost-sharing and prior authorization for OTC contraceptives,” among other approaches.

The Catechism of the Catholic Church explicitly refers to contraception as a “morally unacceptable” form of birth regulation, stating that “every action” that “proposes … to render procreation impossible” is “intrinsically evil.”

The U.S. Conference of Catholic Bishops in July of this year condemned the FDA’s approval of the OTC pill, with Winona–Rochester Bishop Robert Barron stating that the pill’s over-the-counter approval “violates the Hippocratic Oath by putting the health of women at grave risk.”

“This action by a government entity flies in the face of responsible medical practice and concerns for women’s health,” Bishop Barron said at the time. He pointed to the “strong evidence of the many harmful risks of hormonal contraception to women’s health.”

Contraception coverage has been a contentious part of U.S. health care policy for years. Following the passage of the Affordable Care Act, the Obama administration mandated broad coverage of contraceptives in health insurance plans, including for policyholders who object to birth control on religious or moral grounds. 

In 2020, the Little Sisters of the Poor, a Catholic religious institute organization, won a victory at the U.S. Supreme Court affirming the legality of a “moral exemption” to the coverage that had been asserted by the Trump administration. 

The Supreme Court had earlier issued a narrow religious exemption to the mandate for some corporations in the 2014 decision Burwell v. Hobby Lobby Stores, Inc.

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